Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFG |
dARK ID: | ark:/38995/0013000000qc5 |
Texto Completo: | http://repositorio.bc.ufg.br/tede/handle/tede/6271 |
Resumo: | Prematurity is one of the main causes of infant mortality and morbidity associated with perinatal conditions, being responsible for the majority of neonatal deaths in Brazil. Exclusive Breastfeeding (EBF) is one of the main interventions for neonatal deaths reduction, being recommended for early start and keeping until six months of age. However, breastfeeding a premature infant (PT) is a challenge given its physiological and biological immaturity, unstable health and hospitalization. EBF level is low among PT and early weaning is frequent. It is important to know the factors that contribute to this circumstance. Thus, this study assessed EBF incidence and associated risk factors for EBF interruption in PT after 15 days of hospital discharge. It is a prospective cohort accomplished in a public maternity of Goiás with 113 PT admitted in the neonatal unit. Data about PT feeding, since birth until 15 days after hospital discharge, were collected from PT’s medical chart and interview with the mother using a semi-structured questionnaire. EBF interruption of PT 15 days after hospital discharge was considered as the outcome variable and several maternal and neonatal exposure variables were tested. Data quantitative analysis of PT’s gestation, birth and health conditions was done through descriptive statistics. Maternal and neonatal exposure effects on the outcome variable were evaluated through COX regression model. Variables that presented statistical significance (p<0.10) in the univariate analysis were included in the backward multivariate regression model. Significant variables in the model (p<0.05) were interpreted by the hazard ratio (Hazard Risk – HR) and the respective 95% confidence interval. EBF incidence was 81.4% in hospital discharge and 66.4% 15 days after hospital discharge. In the univariate analysis, variables: breast problems, double pregnancy, gestational age at birth, birth weight, admittance time, ventilation time and effective breastfeeding in the first week of life were statistically significant. In the multivariate analysis, variables double gestation, ventilation time and birth weight were statistically significant. A 15% decrease in EBF incidence can be verified 15 days after hospital discharge. EBF interruption risk at home is higher when PT is born from double pregnancy and the lower the PT’s birth weight. On the other side, EBF interruption risk at home is lower the lower the mechanic ventilation time. The implementation of actions is necessary by a multi-professional staff that promotes early start and keeping of EBF during hospitalization in the neonatal unit, as well as the articulation of these actions with basic care and public policies to increase EBF levels from birth up to six months of life. |
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Castral, Thaíla Corrêahttp://lattes.cnpq.br/891012524159121Castral, Thaíla CorrêaScochi, Carmen Gracinda SilvanMinamisava, RuthVieira, FlavianaSalge, Ana Karina Marqueshttp://lattes.cnpq.br/2716214711307732Luz, Lucyana Silva2016-09-26T12:06:07Z2016-04-14LUZ, L. S. Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros. 2016. 90 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2016.http://repositorio.bc.ufg.br/tede/handle/tede/6271ark:/38995/0013000000qc5Prematurity is one of the main causes of infant mortality and morbidity associated with perinatal conditions, being responsible for the majority of neonatal deaths in Brazil. Exclusive Breastfeeding (EBF) is one of the main interventions for neonatal deaths reduction, being recommended for early start and keeping until six months of age. However, breastfeeding a premature infant (PT) is a challenge given its physiological and biological immaturity, unstable health and hospitalization. EBF level is low among PT and early weaning is frequent. It is important to know the factors that contribute to this circumstance. Thus, this study assessed EBF incidence and associated risk factors for EBF interruption in PT after 15 days of hospital discharge. It is a prospective cohort accomplished in a public maternity of Goiás with 113 PT admitted in the neonatal unit. Data about PT feeding, since birth until 15 days after hospital discharge, were collected from PT’s medical chart and interview with the mother using a semi-structured questionnaire. EBF interruption of PT 15 days after hospital discharge was considered as the outcome variable and several maternal and neonatal exposure variables were tested. Data quantitative analysis of PT’s gestation, birth and health conditions was done through descriptive statistics. Maternal and neonatal exposure effects on the outcome variable were evaluated through COX regression model. Variables that presented statistical significance (p<0.10) in the univariate analysis were included in the backward multivariate regression model. Significant variables in the model (p<0.05) were interpreted by the hazard ratio (Hazard Risk – HR) and the respective 95% confidence interval. EBF incidence was 81.4% in hospital discharge and 66.4% 15 days after hospital discharge. In the univariate analysis, variables: breast problems, double pregnancy, gestational age at birth, birth weight, admittance time, ventilation time and effective breastfeeding in the first week of life were statistically significant. In the multivariate analysis, variables double gestation, ventilation time and birth weight were statistically significant. A 15% decrease in EBF incidence can be verified 15 days after hospital discharge. EBF interruption risk at home is higher when PT is born from double pregnancy and the lower the PT’s birth weight. On the other side, EBF interruption risk at home is lower the lower the mechanic ventilation time. The implementation of actions is necessary by a multi-professional staff that promotes early start and keeping of EBF during hospitalization in the neonatal unit, as well as the articulation of these actions with basic care and public policies to increase EBF levels from birth up to six months of life.A prematuridade é uma das principais causas de mortalidade e morbidade infantil associada a condições perinatais, sendo responsável pela maioria das mortes neonatais no Brasil. O Aleitamento Materno Exclusivo (AME) é uma das principais intervenções para redução das mortes neonatais, sendo recomendado o início precoce e a manutenção do AME até os seis meses de idade. No entanto, amamentar um prematuro (PT) é um desafio diante da sua imaturidade fisiológica e biológica, a saúde instável, e a própria hospitalização. A taxa de AME é baixa entre os PT, sendo frequente o desmame precoce. É importante conhecer os fatores que contribuem para esta situação. Assim, este estudo avaliou a incidência do AME e fatores de risco associados à interrupção de AME em PT após 15 dias da alta hospitalar. Trata-se de uma coorte prospectiva realizada em uma maternidade pública de Goiás com 113 PT admitidos na unidade neonatal. Os dados sobre a alimentação do PT, desde o nascimento até 15 dias a alta hospitalar, foram coletados no prontuário do PT e entrevista com a mãe utilizando um questionário semiestruturado. Considerou-se como desfecho a interrupção do AME do PT 15 dias após a alta hospitalar e foram testadas diversas variáveis de exposição maternas e neonatais. A análise quantitativa dos dados de gestação, nascimento e condições de saúde do PT foi feita por meio de estatística descritiva. O efeito das variáveis de exposição maternas e neonatais na variável de desfecho foi avaliado por meio do modelo de regressão de COX. As variáveis que apresentaram significância estatística (p<0,10) na análise univariada foram incluídas no modelo de regressão multivariada backward. As variáveis significantes no modelo (p<0,05) foram interpretadas pela razão de risco (Hazard Risk – HR) e o respectivo intervalo de confiança de 95%. A incidência de AME foi de 81,4% na alta hospitalar e 66,4% 15 dias após a alta hospitalar. Na análise univariada, as variáveis: problemas com as mamas, gestação dupla, idade gestacional ao nascer, peso ao nascer, tempo de internação, tempo de ventilação, e amamentação eficaz na primeira semana de vida foram estatisticamente significantes. Na análise multivariada, as variáveis gestação dupla, tempo de ventilação e peso ao nascer se mostraram estatisticamente significativas. Verifica-se uma queda de 15% na incidência de AME após a alta hospitalar. O risco de interrupção de AME no domicílio é maior quando o PT nasce de gestação dupla, e quanto menor o peso do PT ao nascer. Por outro lado, o risco de interrupção do AME no domicílio é menor quanto menor o tempo em ventilação mecânica. É necessária a implementação de ações pela equipe multiprofissional que promovam o início precoce e manutenção do AME durante a hospitalização em unidade neonatal, bem como articulação dessas ações com a atenção básica e políticas públicas para aumentar a taxa de AME desde o nascimento até os seis meses de vidaSubmitted by Cássia Santos (cassia.bcufg@gmail.com) on 2016-09-23T11:50:22Z No. of bitstreams: 2 Dissertação - Lucyana Silva Luz - 2016.pdf: 1776714 bytes, checksum: 604ffdfdf76f3f046fd4b7fc19fb5810 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-09-26T12:06:07Z (GMT) No. of bitstreams: 2 Dissertação - Lucyana Silva Luz - 2016.pdf: 1776714 bytes, checksum: 604ffdfdf76f3f046fd4b7fc19fb5810 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2016-09-26T12:06:07Z (GMT). No. of bitstreams: 2 Dissertação - Lucyana Silva Luz - 2016.pdf: 1776714 bytes, checksum: 604ffdfdf76f3f046fd4b7fc19fb5810 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-04-14Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESapplication/pdfporUniversidade Federal de GoiásPrograma de Pós-graduação em Enfermagem (FEN)UFGBrasilFaculdade de Enfermagem - FEN (RG)http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessAmamentaçãoPrematuroEnfermagem neonatalBreastfeendingPrematureNeonatal nursingCIENCIAS DA SAUDE::ENFERMAGEMIncidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematurosIncidence and predictive factors of exclusive breastfeending interruption in premature infantsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis45061628303650419816006006006002756753233336908714-77028265330109643272075167498588264571reponame:Repositório Institucional da UFGinstname:Universidade Federal de Goiás (UFG)instacron:UFGLICENSElicense.txtlicense.txttext/plain; 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dc.title.por.fl_str_mv |
Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros |
dc.title.alternative.eng.fl_str_mv |
Incidence and predictive factors of exclusive breastfeending interruption in premature infants |
title |
Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros |
spellingShingle |
Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros Luz, Lucyana Silva Amamentação Prematuro Enfermagem neonatal Breastfeending Premature Neonatal nursing CIENCIAS DA SAUDE::ENFERMAGEM |
title_short |
Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros |
title_full |
Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros |
title_fullStr |
Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros |
title_full_unstemmed |
Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros |
title_sort |
Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros |
author |
Luz, Lucyana Silva |
author_facet |
Luz, Lucyana Silva |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Castral, Thaíla Corrêa |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/891012524159121 |
dc.contributor.referee1.fl_str_mv |
Castral, Thaíla Corrêa |
dc.contributor.referee2.fl_str_mv |
Scochi, Carmen Gracinda Silvan |
dc.contributor.referee3.fl_str_mv |
Minamisava, Ruth |
dc.contributor.referee4.fl_str_mv |
Vieira, Flaviana |
dc.contributor.referee5.fl_str_mv |
Salge, Ana Karina Marques |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/2716214711307732 |
dc.contributor.author.fl_str_mv |
Luz, Lucyana Silva |
contributor_str_mv |
Castral, Thaíla Corrêa Castral, Thaíla Corrêa Scochi, Carmen Gracinda Silvan Minamisava, Ruth Vieira, Flaviana Salge, Ana Karina Marques |
dc.subject.por.fl_str_mv |
Amamentação Prematuro Enfermagem neonatal |
topic |
Amamentação Prematuro Enfermagem neonatal Breastfeending Premature Neonatal nursing CIENCIAS DA SAUDE::ENFERMAGEM |
dc.subject.eng.fl_str_mv |
Breastfeending Premature Neonatal nursing |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::ENFERMAGEM |
description |
Prematurity is one of the main causes of infant mortality and morbidity associated with perinatal conditions, being responsible for the majority of neonatal deaths in Brazil. Exclusive Breastfeeding (EBF) is one of the main interventions for neonatal deaths reduction, being recommended for early start and keeping until six months of age. However, breastfeeding a premature infant (PT) is a challenge given its physiological and biological immaturity, unstable health and hospitalization. EBF level is low among PT and early weaning is frequent. It is important to know the factors that contribute to this circumstance. Thus, this study assessed EBF incidence and associated risk factors for EBF interruption in PT after 15 days of hospital discharge. It is a prospective cohort accomplished in a public maternity of Goiás with 113 PT admitted in the neonatal unit. Data about PT feeding, since birth until 15 days after hospital discharge, were collected from PT’s medical chart and interview with the mother using a semi-structured questionnaire. EBF interruption of PT 15 days after hospital discharge was considered as the outcome variable and several maternal and neonatal exposure variables were tested. Data quantitative analysis of PT’s gestation, birth and health conditions was done through descriptive statistics. Maternal and neonatal exposure effects on the outcome variable were evaluated through COX regression model. Variables that presented statistical significance (p<0.10) in the univariate analysis were included in the backward multivariate regression model. Significant variables in the model (p<0.05) were interpreted by the hazard ratio (Hazard Risk – HR) and the respective 95% confidence interval. EBF incidence was 81.4% in hospital discharge and 66.4% 15 days after hospital discharge. In the univariate analysis, variables: breast problems, double pregnancy, gestational age at birth, birth weight, admittance time, ventilation time and effective breastfeeding in the first week of life were statistically significant. In the multivariate analysis, variables double gestation, ventilation time and birth weight were statistically significant. A 15% decrease in EBF incidence can be verified 15 days after hospital discharge. EBF interruption risk at home is higher when PT is born from double pregnancy and the lower the PT’s birth weight. On the other side, EBF interruption risk at home is lower the lower the mechanic ventilation time. The implementation of actions is necessary by a multi-professional staff that promotes early start and keeping of EBF during hospitalization in the neonatal unit, as well as the articulation of these actions with basic care and public policies to increase EBF levels from birth up to six months of life. |
publishDate |
2016 |
dc.date.accessioned.fl_str_mv |
2016-09-26T12:06:07Z |
dc.date.issued.fl_str_mv |
2016-04-14 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
LUZ, L. S. Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros. 2016. 90 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2016. |
dc.identifier.uri.fl_str_mv |
http://repositorio.bc.ufg.br/tede/handle/tede/6271 |
dc.identifier.dark.fl_str_mv |
ark:/38995/0013000000qc5 |
identifier_str_mv |
LUZ, L. S. Incidência e fatores preditivos da interrupção de aleitamento materno exclusivo em prematuros. 2016. 90 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2016. ark:/38995/0013000000qc5 |
url |
http://repositorio.bc.ufg.br/tede/handle/tede/6271 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.program.fl_str_mv |
4506162830365041981 |
dc.relation.confidence.fl_str_mv |
600 600 600 600 |
dc.relation.department.fl_str_mv |
2756753233336908714 |
dc.relation.cnpq.fl_str_mv |
-7702826533010964327 |
dc.relation.sponsorship.fl_str_mv |
2075167498588264571 |
dc.rights.driver.fl_str_mv |
http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal de Goiás |
dc.publisher.program.fl_str_mv |
Programa de Pós-graduação em Enfermagem (FEN) |
dc.publisher.initials.fl_str_mv |
UFG |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Faculdade de Enfermagem - FEN (RG) |
publisher.none.fl_str_mv |
Universidade Federal de Goiás |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UFG instname:Universidade Federal de Goiás (UFG) instacron:UFG |
instname_str |
Universidade Federal de Goiás (UFG) |
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UFG |
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UFG |
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Repositório Institucional da UFG |
bitstream.url.fl_str_mv |
http://repositorio.bc.ufg.br/tede/bitstreams/96261645-6b4e-465b-b15d-d02f170ea938/download http://repositorio.bc.ufg.br/tede/bitstreams/69b10839-5994-4cfa-a8a5-9431c0bc3168/download http://repositorio.bc.ufg.br/tede/bitstreams/de2ae68f-df70-4472-b0e5-364bdce83b4e/download http://repositorio.bc.ufg.br/tede/bitstreams/414e83dc-d65f-4ad9-94e2-d0c4aef8c7b7/download http://repositorio.bc.ufg.br/tede/bitstreams/9005cc29-1da5-44fc-affb-ac60b1cf8d84/download |
bitstream.checksum.fl_str_mv |
bd3efa91386c1718a7f26a329fdcb468 4afdbb8c545fd630ea7db775da747b2f d41d8cd98f00b204e9800998ecf8427e d41d8cd98f00b204e9800998ecf8427e 604ffdfdf76f3f046fd4b7fc19fb5810 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 MD5 MD5 |
repository.name.fl_str_mv |
Repositório Institucional da UFG - Universidade Federal de Goiás (UFG) |
repository.mail.fl_str_mv |
tasesdissertacoes.bc@ufg.br |
_version_ |
1815172516610572288 |